Yes, you are a bad person

The American Right, defenders of individual liberty, are back in our business. They are appalled—appalled—that contraception is popular. For a group that is explicitly “pro-life”, this is an indefensible position. Here’s why they’re wrong, and why it’s not just a political disagreement.

I’m going to pull the authority card out here: I’ve spent the better part of eleven years practicing medicine. Before that I spent four years as an undergraduate, four years in medical school, and three years as a medical resident. I’ve had a chance to learn a few things about medicine. I’ve also had a chance to learn a lot about people over the last several years; my patients have a lot to teach me, and I keep my ears open, because there is no end to learning. To learn you must be humble, and nothing is more humbling than disease. The human body can suddenly and spectacularly fail without regard to a person’s age or moral character, and a lot of the time, there’s not a damned thing you can do but order a nice smoked fish plate for shiva.

The recent arguments about female contraception fall into a few distinct categories—allegedly:

Political: “I don’t care what you do or what you take but I don’t want my tax dollars funding it.”

Religious: “My religion forbids contraception, therefore I don’t have to give it to you.”

Moral: “Contraception is wrong and is part of what is destroying our society.”

The political is odd, in that it seems patently fringe. It’s no secret that I think that libertarians are simply anarchists with haircuts, and are only libertarians so long as they are better armed than their neighbors. Beyond my personal bias, the argument is invalid. The recent argument is about insurance coverage of female contraception. The administration and Congress, through the passage of the Affordable Care Act, have made preventative care a priority, and as part of this, health care plans may not discriminate against women in the provision of preventative services. Among these services is contraception. This is medically valid: contraception in its many forms is good medicine, part of the standard of care. Failure to provide it appropriately could be construed as malpractice. The libertarian argument is, in its pure form, simple nihilism. If the argument is, “don’t use my taxes for stuff I don’t like,” then what they really are saying is, “taxation is illegitimate.” There is no “government pays for sex” clause. This is a clumsy ruse.

Contraception can be used for preventing pregnancy and other just as legitimate medical uses. You don’t—like a condom—use it when you feel like having sex. Most female contraceptives are used daily. If you skip pills, you aren’t protected. There is no “pay to play”. And the government isn’t paying: the consumer is. When you look at your paystub and see the insurance deduction, that’s your money, paying for your health care. The “government” didn’t pay, Rush Limbaugh didn’t pay, President Obama didn’t pay: you did. It’s your right to get equal treatment.

The religious objection is somewhat more morally consistent (often). The Catholic Church, for example, has always been explicitly against contraception. I think that’s insane and morally untenable, but it’s their right to believe it and preach it. It is not, in a pluralistic society, their right to deny equal care to their employees based on sex. (Actually, they can do that among certain Church employees, but whatever.) If the Church, through one of its institutions in the US decides to provide health insurance (a morally laudable practice) they cannot discriminate based on sex. That’s against the law, and not morally laudable. If they are truly serious about removing all hints of support for contraception, they must eliminate all insurance coverage (and pursue the majority of American Catholics who use contraception, but what do I know about Church law?). I wonder how that would go over?

The moral objection, as usually stated by public figures, is pretty much insane, but once again, their right. It is not “pro-life”, but pro-poverty and pro-diseae. Family planning confers enormous benefits to a society. It reduces infant, child, and maternal mortality; improves education, especially for women and girls; reduces transmission of HIV; and reduces poverty. It’s one of the most useful public health measures imaginable. To be against it is to be against these benefits—once again, your right, but not particularly laudable. What is less offensive is refusing yourself to use medications that violate your beliefs. What is gravely offensive is trying to deny these benefits to others.

So is this all just a moral/political/religious disagreement? Can we shake hands and agree to disagree?

No, and maybe.

In this country, one of laws and not of the arbitrary wishes of individuals, those who wish to deny rights to others are not on the side of good.

Those who would mock, attack, and defame those who choose to exercise their rights in an attempt to intimidate are bad people. Rush Limbaugh can believe and say whatever he wants, but he is not immune from criticism and judgement. He and others like him (and the presidential candidates who refused to condemn or even disagree with him) are not good people. They are opportunistic at best, evil at worst.

19 Comments

Good post. Pretty outrageous to have this kind of debate in 2012, largely among a bunch of older men, many of whom have practiced family planning in their personal lives. And I think the debate over this has forgotten that in most Western countries, the balance is towards the rights of individuals, not the rights of institutions.

The tax issue is particularly ridiculous, given that there are many things that government spends money on, but healthcare is not one of them.

Alexis

I have also had people (notably, usually older/middle aged men) tell me, smugly, that “birth control is a lifestyle choice” and “Pregnancy is not a disease to be prevented.” (The latter is literally true but also completely misses the point.) Also, that I can just pay out of pocket if it’s so important to me.

I’ve had 2 high risk pregnancies, and my desire not to put myself in harm’s way a third time (at least not for the foreseeable future) is not a “lifestyle choice”, it’s a rational medical decision—one my OB/GYN was very much in favor of.

As far as I can tell, the anti-contraception folks argument boils down to:

“Pregnancy is a gift from God to punish you for being a horrible slut.”

Until the anti-contraception folks start forcing men to submit to fertility tests and prove they are married, before prescribing viagra, I will continue to see this, not as a reflection of their morals about sex but as the misogynistic attack on women that it is.

Lisa C.

that is one of the most thoughtful/ well-reasoned things i have read about this debate so far (you can tell i’ve read too much from the newspapers). It is interesting to me that this debate focuses so much on women and putting all the responsibility on them- ie if you choose to have a one night stand then you MUST have that child, too! well what about the man??? I dont particularly appreciate old white men making decisions that affect me, my body, and my life.

I so want to comment but every time I try, I start spluttering in fury. Thank goodness you and other reasonable people can stay calm enough to call out the misogynistic lunatics. I have a semi-serious concern that if contraception isn’t covered, pretty soon owning a uterus will be a pre-existing condition, and any medical expense related to that, including pregnancy and delivery of course, will not be covered.

I’m deeply depressed by the fact that these old white dudes seem able to find any sexual partners other than each other. The fact that they claim to have had sexual relationships with women and still remain appallingly ignorant of basic anatomy is tragic.

DLC

AL Chism

That this issue is even being “debated” in 2012 lends a disturbing surreal quality to political discourse. That the “pro-life” side of the argument cares about protecting the fetus, but refuses suport of the resultant child is truly alarming and unsustainably hypocritical. However, you have to give it to those Noe-cons, they have managed, by dint of unrelenting jingoism, to whip the credulous and the intolerant into an absolute frenzy over something that is essentially none of their business. What a horrid farce.

GregfromCanada

Thank you PalMD for a well reasoned comment. In a way I’m glad these people are bring this issue up again in that it shows their true stripes, but I wish this issue was settled and far behind us. We as a civilization have better/more important things to focus on.

One small thing, and hope it doesn’t come off as too pedantic, but I in your piece where you say “but once again, their right” rather than “it’s their right”, which made me pause for a moment when I read it even though I knew what you meant.

@Hansa,
While it is true that hormonal contraception is used to treat some illnesses, framing other uses for it as the “real medical purpose” simply promotes the idea that the most common use for the pill is something to be judged. It’s like making exceptions for abortions in cases of rape or incest. Yes, those are particularly egregious, but any woman should have ready access to abortion, not just those who got pregnant in a way some congress people deemed “moral.” By focusing on the less common exceptions, we bolster the idea that these are moral not medical discussions and I think that line hurts the cause.

I find the argument ““I don’t care what you do or what you take but I don’t want my tax dollars funding it.” repugnant. While we can discuss policy overall regarding where our tax dollars go- we don’t get to pick and choose. There are many things that I don’t want my tax dollars funding – but that’s just not the way it’s done.

Further, on all 3 or the arguments you note, I find it even MORE repugnant that the public discourse centers on the woman’s role. I see very little of the mens role in all of this. Disgusting, and incredibly revealing.

To me, religion isn’t even supposed to be part of government. I mean, American Indian religions were technically illegal until the 1970s, and fundamentalists complain about tax dollars to support contraception as “oppressive”? LOL